DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

INSPECTION REPORT
Facility Information






 




 








 
Inspection Information








DocumentDocument-Date
SAMPLE WEEKLY MENU 10/04/2012
POLICIES 09/04/2008
OWNER/PROVIDER REFERENCES 08/27/2004
DIAGRAM/OUTDOOR 10/04/2012
DIAGRAM/INDOOR 10/04/2004
DAILY SCHEDULE 10/04/2004
CHILD CARE/DISCIPLINE POLICIES 09/04/2008
ASSISTANT REFERENCES 08/17/2012
ASSISTANT APPROVAL REQUEST 08/09/2016
EQUIPMENT LIST 09/13/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 09/16/2023
ANNUAL DECLARATION 09/13/2023
SANITATION INSPECTION 07/13/2023
FIRE/SAFETY INSPECTION 07/18/2023
SAFE SLEEP POLICY 10/17/2023

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   5:30PM   10/24/2022



Open Violations:
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

 
5 CSR 25-400.025 Organization and Administration
Compliance
5 CSR 25-400.045 Licensing Process
Compliance
5 CSR 25-400.055 Annual Requirements
Violation
 Provider Comments
Violation
The equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (B) states: A current list of available equipment.
Correction Required
The child care provider shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date
9/13/2023
Violation
The listing of household members and assistants did not include all household members as evidenced by provider did not include herself in the caregiver listing.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (C) states: A listing of household members and assistant(s).
Correction Required
The child care provider shall submit a listing of all household members and assistants.

Correction Verification
Submit Documentation

Compliance Date
9/16/2023
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed family child care home and agreement to comply with all statutes and department licensing rules;
Correction Required
The child care provider shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date
9/13/2023
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by the resilient material used is unapproved as evidenced by large pieces of wood mulch that are sharp and splintery, measuring up to 11".
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 6. states: The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact absorbing materials which effectively cushions the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material. Grass may be an approved resilient material, but if grass becomes worn or sparse, the area must be covered with another approved resilient material.
Correction Required
The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.086 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the evacuation time was not recorded.
Licensing Rule Reference
5 CSR 25-400.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.090 Disaster and Emergency Preparedness
Compliance
5 CSR 25-400.095 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
Arrangement of sleeping equipment was not met as evidenced by the aisle on the long side of napping equipment was too narrow and measured less than 24 inches.
Licensing Rule Reference
5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 1 E states: Sleeping equipment shall be arranged to provide at least a two-foot (2') aisle on one (1) long side of the equipment.
Correction Required
The facility shall maintain a two-foot (2') aisle as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel
Violation
 Provider Comments
Violation
Verification of safe sleep training was not documented and maintained for the assistant(s), Lindsey Smith, has safe sleep training certificate with her name, but the MOPD ID number is Catherine Maxwell's number.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) 1. states: The training shall be documented and maintained as described in paragraph (4)(E)2. of this rule.
Correction Required
Safe sleep training shall be documented and maintained.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.115 Child Care Family and Household
Compliance
5 CSR 25-400.125 Medical Examination Reports
Compliance
5 CSR 25-400.135 Admission Policies and Procedures
Compliance
5 CSR 25-400.145 Nighttime Care
Compliance
5 CSR 25-400.155 Overlap Care of Children
Compliance
5 CSR 25-400.165 Emergency School Closings
Compliance
5 CSR 25-400.175 Child Care Program
Compliance
5 CSR 25-400.185 Health Care
Compliance
5 CSR 25-400.190 Nutrition and Food Service
Compliance
5 CSR 25-400.200 Transportation and Field Trips
Compliance
5 CSR 25-400.210 Records and Reports
Violation
 Provider Comments
Violation
1 child(ren) records did not include date care begins and ends.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (2) (A) states: The child’s full name, address, birth date and the date care begins and ends.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
10/17/2023
5 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 Background Screening Findings
Compliance
RSMo 210.115. Reports of abuse, neglect, and under age eighteen deaths - persons required to report - supervisors and administrators not to impede reporting - deaths required to be reported to the division or child fatality review panel, when - report made to another state, when.
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance